[Radiotherapy and bisphosphonate therapy in bone metastases of prostate carcinoma]

Prostate carcinoma patients with bone metastases do not have a dismal prognosis or short life expectancy by itself. Thus, often palliative therapeutic measures are required with respect of a life span beyond one year, especially if no lyphogenic or visceral metastases have developed. Similarly to patients with breast carcinoma the metastatic bone lesions in prostate carcinoma patients have mixed osteolytic and osteoblastic features with increased metabolic bone turn-over. This is the mechanism, in which bisphosphonates interfere and can prevent the pathologic bone resorption by blocking osteoclast activity. This improves not only painful clinical conditions but also reduces the rate of skeletal related events (SRE = hypercalcemia, bone fracture, myelon compression, surgery or radiotherapy to bone etc.). Generally, clinical studies suggest the benefit of bisphosphonates for patients with bone metastases and good life expectancy. For patients with prostate carcinoma large controlled studies have to consolidate this potential benefit.